What question did this study set out to answer?

This case report aims to illustrate the occurrence of Shiga toxin-producing E. coli-associated hemolytic uremic syndrome in a patient undergoing chemotherapy for ovarian cancer.

April 3, 2026Cureus0 citationsOpen Access

Shiga Toxin-Producing Escherichia coli-Associated Hemolytic Uremic Syndrome Following Neoadjuvant Chemotherapy for Advanced Ovarian Cancer: A Case Report

RDRatko DelićCollege of Nursing in Celje

Key Points

This case report aims to illustrate the occurrence of Shiga toxin-producing E. coli-associated hemolytic uremic syndrome in a patient undergoing chemotherapy for ovarian cancer.
Document a case of a 55-year-old woman with advanced ovarian cancer receiving neoadjuvant chemotherapy.
Detail the development of thrombotic microangiopathy and acute kidney injury.
Describe management strategies including supportive care and dialysis.
The patient developed severe oligo-anuric acute kidney injury.
Multiple transfusions were needed to manage her condition.
Early recognition and multidisciplinary management were crucial for stabilization.

Abstract

Hemolytic uremic syndrome (HUS) is an uncommon but serious cause of thrombotic microangiopathy (TMA) in adults and can pose diagnostic challenges, especially in patients receiving chemotherapy, due to overlapping features with chemotherapy-induced TMA. We report the case of a 55-year-old woman with advanced ovarian cancer undergoing neoadjuvant chemotherapy who developed Shiga toxin-producing Escherichia coli (STEC)-associated HUS. The patient developed severe oligo-anuric acute kidney injury (AKI), requiring hemodialysis and multiple transfusions. Early recognition, prompt supportive care, and multidisciplinary management were critical for stabilization and safe continuation of oncologic therapy. This case highlights the importance of considering STEC-HUS in immunocompromised adults presenting with TMA during oncologic chemotherapy.

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